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How would a Home Health Nurse Reform Healthcare?

Our goal at Ankota is to improve the delivery of healthcare. We think everyday about how healthcare should be reformed, and we focus on the areas where we know we can make an impact. We are convinced that the solution is to focus on the most expensive patients and to proactively manage and coordinate their care, keeping them at home. But today's post is very special because it comes from a home health nurse who validates our vision.. We're pleased to introduce Beth Kennedy, a home health nurse in northern Virginia. Here's Beth's view...

The question on everyone's mind is how to do we lower healthcare costs while still providing optimal care to our patients? If someone could solve this problem we could all sleep better at night. That being said, it appears that the healthcare industry continues to spiral out of control. I say this as a healthcare professional. I am a nurse who works in home healthcare. My goal is to assist patients in coordinating their medical needs after discharge from the hospital. This can be quite an overwhelming task because it can range from physical needs to medication discrepancies to social and economic issues and also the need or lack of medical supplies and equipment such as wheel chairs or walkers or gauze/bandages.

Collaboration in the release of a patient to home care is a critical component. Even though it is a critical component, it almost always lacking in details and results in incomplete discharge orders and unclear instructions for home health management of the patient. The end result? The patient does not get the adequate care he/she needs and his/her condition continues to depreciate in the home and he/she ends up back at the doctors office and usually admitted back into the hospital. From a monetary perspective, this costs the healthcare industry a lot of money. And if it was just one patient, swallowing the money would not be too difficult, but this happens every day all around the country to thousands of patients.

One idea on how to fix this disastrous chain of events is to streamline discharge care. Even though hospitals function as separate units, this is a country-wide issue. Proposing a standard federal policy of discharge (or at least state) is a step in the right direction. There should be specific steps that are always taken prior to discharging a patient from a hospital setting: meeting with family members or primary caregivers to discuss discharge process, assessment of home environment prior to discharge (for safety issues), review of medications that need to be taken once discharged (and a way to make sure patient has access to this medication), home health service assigned to patient by hospital staff so that a planning meeting can be established and the home health nurse is in communication with hospital staff (mainly doctor and nurse that discharged patient).

Some hospitals have case managers that are responsible for discharge planning. Most do their best to ensure a positive discharge, but hospitals are super busy and staff is overworked. Their only goal is to "get the patient out the door." They are not seeing the big picture --- that we should be trying to keep the patient out for good and prevent a readmission.

Hospital administrators need to hand down the information to case managers, nurses and doctors that the overall goal of the hospital is to prevent readmission. More time and energy needs to be focused on coordinating outside care and collaborating with family members, obtaining proper medications and explaining the process of taking care of a patient in the home.

Without this necessary process being done, patients will continue to decline in the home and wind up readmitted to the hospital and also continuing to waste thousands of dollars for readmittance to the hospital.

Communication and education are two of the most important parts of the patient-discharge process. Healthcare professionals are too busy to have these much-needed conversations with patients and their families. But we are seeing, the end result, is that the lack of communication and education is causing readmission to hospitals and strains on the economy.

Ankota provides software to improve the delivery of care outside the hospital. Today Ankota services home health, private duty care, DME Delivery, RT, Physical Therapy and Home Infusion organizations, and is interested in helping to efficiently manage other forms of care. To learn more, please visit www.ankota.com or contact Ankota